Provider Demographics
NPI:1063772093
Name:HITTEL, KATHERINE LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LOUISE
Last Name:HITTEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATE
Other - Middle Name:LOUISE
Other - Last Name:BRERETON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3502 HENDERSON BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3970
Mailing Address - Country:US
Mailing Address - Phone:813-738-3898
Mailing Address - Fax:
Practice Address - Street 1:3502 HENDERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3970
Practice Address - Country:US
Practice Address - Phone:813-738-3898
Practice Address - Fax:813-642-4893
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLPY9243103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program